Active NPI
Vicki L Bralow, DO
- Family Medicine Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0S006570L
- Practice address
- 834 South St
Philadelphia, PA 19147-2025 - Phone
- (215) 832-0135
- Fax
- (610) 660-0877
- NPI assigned
- Oct 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0S006570L | PA | Primary |
Addresses
Primary practice location
834 South St
Philadelphia, PA 19147-2025
Mailing address
200 W Washington SQ Apt 3707
Philadelphia, PA 19106-3538
Phone (215) 832-0135
Other practice location 1
732 S 8th Street
Philadelphia, PA 19147
Phone (215) 922-4707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Philadelphia College of Osteopathic Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
420 Bainbridge St
Suite 201
Philadelphia, PA 19147-1568
Phone (215) 832-0130
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0S006570L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philly Wellness Center LLC | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Philadelphia, PA
- NPI 1023556875
-
- Nurse Practitioner
- Philadelphia, PA
- NPI 1215702279
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phila, PA
- NPI 1063489342
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1851370910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962588335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W WASHINGTON SQ APT 3707",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191063538",
"telephone_number": "215-832-0135",
"fax_number": "610-660-0877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191472025",
"telephone_number": "215-832-0135",
"fax_number": "610-660-0877"
}
],
"practiceLocations": [
{
"address_1": "732 S 8th Street",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "19147",
"country_code": "US",
"telephone_number": "215-922-4707",
"fax_number": "215-922-4709",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRALOW",
"first_name": "VICKI",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "0S006570L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.